Individual provider Active NPI

Christopher Kanayo Agu, N/A

  • Durable Medical Equipment & Medical Supplies
  • Long Beach, CA
National Provider Identifier
1902903552
Registry record updated Sep 19, 2008
On this page

OIG exclusion record

The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:

  • Section 1128a(1) exclusion effective Dec 18, 2014.

Matched on NPI only. Confirm current status with the OIG exclusions search before relying on it.

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
44820 Issued in CA
Practice address
3711 Long Beach Blvd Ste 214
Long Beach, CA 90807-3319
Phone
(562) 426-3659
Fax
(562) 492-1206
NPI assigned
Sep 17, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 19, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 44820 CA Primary

Addresses

Primary practice location

3711 Long Beach Blvd Ste 214
Long Beach, CA 90807-3319

Mailing address

3711 Long Beach Blvd Ste 214
Long Beach, CA 90807-3319
Phone (562) 426-3659

Other identifiers 1

IdentifierTypeStateIssuer
DME03398FMedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
44820CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Healthview Medical Supply Durable Medical Equipment & Medical Supplies Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1221782400000",
    "number": "1902903552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3711 LONG BEACH BLVD STE 214",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908073319",
            "telephone_number": "562-426-3659",
            "fax_number": "562-492-1206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3711 LONG BEACH BLVD STE 214",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908073319",
            "telephone_number": "562-426-3659",
            "fax_number": "562-492-1206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGU",
        "first_name": "CHRISTOPHER",
        "middle_name": "KANAYO",
        "name_prefix": "Mr.",
        "credential": "N/A",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-17",
        "last_updated": "2008-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "CA",
            "license": "44820",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DME03398F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.